(3)

446

(2)

10. Whether each of the Appointments held by the Applicant has been on the Fixed Establishment

of the Colony,

Yes

11. Whether the duties of the several offices or situations held since the Applicant entered the Civil

Service have been such as to require that the holder should give his whole time to the Public

Service

18. Statement, if the circumstances warrant it, that the Applicant has discharged his duties with "diligence and fidelity, to the satisfaction of the Head Officer or Officers of his Department,' to be signed by any two of such Head Officers, if there shall be more than one, or by such Head Officer if there shall be but one, together with "such a statement as will exhibit the Merit, and value, and labour of the Services of the person recommended, embracing as long as a "period of his public service as can be authentically stated," and observations as to Special Services, Suspension, Reprimand, &c. with full particulars of any injuries received on duty or other claims or matters for consideration,

Yec

12. Whether holding any other Public Appointment, or receiving or claiming to receive any Public

Money by Compensation, Half-pay or otherwise.

No

13. If any kind of Pension or other Allowance has been commuted under the Imperial Pensions

Commutation Acts, 1869 and 1871, and annual amount of Pension or Allowance so commuted

and the date of Commutation should be inserted.

No

19. Computation, by the Colonial Treasurer, of the Pension, &c.

14. Absonce, beyond ordinary Vacation leave:--

Year.

Period of Absence

1895... From 29.4.1899

1987...

1

1987...

1909...

19....

191....

1 444000

1919.....

13

15

11

JA

"1

};

1

1

"

3.

24·2·98

To 14-2-

7.02

7

· ། · ༠1

5. 10.

4

16

ib

29.

J

10.09

10

9. 14

12

14

6.19

"

19 20-11-02

++ 2.4.08

16.

·11-00

15.12.14

» 20-2- 15′′

2110-120

Number of Days.

Cause of Absence.

954 450 mths

Ou

helf pay

tive

9 mtho

28 days

3 mths On Commuted have

2 mb

On half pay heave On Commuted leave

เร

I certify that the

Pension

according to the Rules of the Colonial Service amounts to

and I base my Certificate on the following calculation:-

Length of Service in the two Colonies

Less 11⁄2 of 11⁄2 pay leave - do a

1/2

Salary £1500-

Zolat HK. Salary £24. 195. 12. 11

7ms.

Add

$3.3.20

1. 1. 24

2. 32.

which may be paid to the Applicant

£809.4.8.

446 + £1500 £929.3.4.

= 37. 2.

720

3.585.12. ↑ £ 929.3.4 :: £24.195-12.11 =

27.7.87.10-7.4

The applicant is entitled to draw his pension at the rate of

809.4.8 HHL. Peneran 119 - 18.8 79.5

32

Contribution to Widows' and Orphans' Pensions at the rate of Ep.4.4. ( Mehring heltyper anuum should be deducted, up to the ...............day of...........1935. inclusive,

and the full amount of the pension should thereafter be paid.

15. Date of Cessation of Duty,.......ŝând.

.1824

16, Date of Cessation of Salary,.... Rand. July....1824...............................................

from which, inclusively, Pension will commence,...23rd. Tway, 1924.

Governor, &e,

Colonial Treasurer.

[Instructions.]

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